New Jersey Governor Chris Christie came under fire for slashing $900 million from programs for the poor, individuals with disabilities and senior citizens. Christie affected his usual “I don’t care what you think” attitude and signed a budget that disproportionately hurt those who are already hurting while saying a big “no” to a millionaire’s tax. The cuts outlined in House Speaker John Boehner’s debt ceiling proposal to save $1.5 trillion in entitlement spending are similarly devastating to those who are they most in need. Boehner’s proposal includes cuts to Social Security and Medicare benefits for current retirees; a repeal of coverage extensions provided by the Affordable Care Act; measures that cut Medicare payments; the end of the safety-net for low-income children, parents, senior citizens and individuals with disabilities.
It’s not just Christie who doesn’t care. A new Center on Budget and Policy Priorities (CBPP) report reports that 20 states have made “deep, identifiable cuts” in health care that will reduce access to care for low-income children, seniors, families and individuals with disabilities, says ThinkProgress. From the report:
Arizona has frozen enrollment in part of its Medicaid program, so that an estimated 100,000 low-income people who previously would have qualified will not be able to enter the program, and another 150,000 will face more stringent rules for retaining eligibility. Washington has frozen enrollment for a state-run health plan serving approximately 40,000 low-income residents, which is expected to reduce the number of participants to 37,000 in 2012 and to 33,000 in 2013.
Cuts to Medicare also affect hospitals that disproportionately serve the poor and elderly in urban areas. In New York, teaching hospitals which could lose as much as $1 billion a year if the Medicare subsidy for training doctors and providing intensive medical services — trauma centers, burn units — is cut. The subsidy, which goes back to the 1960s, helped to make New York’s teaching hospitals among the most prestigious in the world, with about 16,000 doctors a year, or 14.5 percent of the nation’s total, more than any other states. Hospital officials say the payments cover the residents’ salaries and benefits and also those of supervising physicians’ salaries and benefits, plus overhead like classroom space.
The subsidies have been criticized by both conservatives and liberals as “sweetheart deal for teaching hospitals in a few states” and a “hidden subsidy” for the operating costs of NYC hospitals. In December, the Simpson-Bowles Commission, which advised President Obama on debt and deficit reduction, called for reducing “excess” payments to hospitals for medical education.
However, as the New York Times points out:
….the administrators of New York’s teaching hospitals say they operate on very thin margins because they serve large proportions of patients who are receiving government insurance for the poor and the elderly, and because they provide some of the most sophisticated — and expensive — medical treatment in the country. Either way, the hospitals have come to depend on the money.
Three New York hospitals — Montefiore Medical Center in the Bronx and Mount Sinai Medical Center and NewYork-Presbyterian Hospital in Manhattan — would suffer the most from the cuts, followed by U.P.M.C.-Presbyterian in Pittsburgh, the Hospital of the University of Pennsylvania in Philadelphia and Massachusetts General Hospital. With 18,000 employees, Montefiore Medical Center is one of the Bronx’s main employers. It trains 1,200 residents at any one time and produces 350 to 400 doctors a year. 80 percent of the hospital’s patients are on either Medicare, or Medicaid, the program for the poor. While Montefiore, a nonprofit institution, has a budget of about $3 billion, its revenues exceed its expenses “by only one percentage point,” all of which is invested back in the hospital.
In lawmakers can’t come to some sort of agreement about raising the federal debt ceiling, individuals with disabilities will be hurt in yet another way: The debt crisis could mean that they’ll end up going without Supplemental Security Income, or SSI, benefits come August. As Disability Scoop says, when asked earlier this week about what will happen to the 70 million Americans who rely on these benefits, President Obama said:
“Well, when it comes to all the checks, not just Social Security — veterans, people with disabilities — about 70 million checks are sent out each month — if we default then we’re going to have to make adjustments. And I’m already consulting with (Treasury) Secretary Geithner in terms of what the consequences would be.”
In other words — all the more if the federal debt ceiling isn’t raised in a week and the US defaults — the message that’s being sent to America’s “poor, tired and hungry” is pretty much, “stay that way.”
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